Provider Demographics
NPI:1407989148
Name:ELIZABETH V. LENER, M.D., INC.
Entity Type:Organization
Organization Name:ELIZABETH V. LENER, M.D., INC.
Other - Org Name:THE DERMATOLOGY CENTER AT LADERA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:VERONIKA
Authorized Official - Last Name:LENER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-364-8411
Mailing Address - Street 1:600 CORPORATE DR STE 240
Mailing Address - Street 2:
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-2111
Mailing Address - Country:US
Mailing Address - Phone:949-364-8411
Mailing Address - Fax:949-364-8511
Practice Address - Street 1:600 CORPORATE DR STE 240
Practice Address - Street 2:
Practice Address - City:LADERA RANCH
Practice Address - State:CA
Practice Address - Zip Code:92694-2111
Practice Address - Country:US
Practice Address - Phone:949-364-8411
Practice Address - Fax:949-364-8511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherFEDERAL EIN
CA=========OtherFEDERAL EIN
CAW18176Medicare PIN